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Hand-Washing
GlovingProcedures
AsepticTechnique
RiskAssessment-Laboratories
RiskAssessment-Paediatrics
RiskAssessment-Physiotherpy
RiskAssessment-Elderly
SharpsDisposal-Venepuncture
SharpsDisposal-Theatres
WasteDisposal
ProcedureinEventofaSharpsInjury
MRSA,ClostridiumDifficile&SwineFlu
Quiz
InfectionandControlEverydaynursesandhealthcareworkersfacetheriskofaneedlestick,splashorhumanbiteinjury.Around100,000peryearoccuramongsthealthcareworkersintheUK.Theriskofdevelopinganinfectionfromablood-bornevirussuchasHepatitisA,HepatitisB,HepatitisCorHIV,asaresultofasharpsinjury,ishigh.Thepurposeofthisappis:Tohighlighttheimportanceofriskassessmentpriortoengaginginanyprocedure.Topromotetheuseofsafepracticeamongstallhealthcareworkers.Toidentifypotentialhazards.Todescribetheprocedureintheeventofasharps,splashorhumanbiteinjury.Topromotetheuseofsafepracticeamongstallhealthcareworkers.Toidentifypotentialhazards.Todescribetheprocedureintheeventofasharps,splashorhumanbiteinjury.
Contents
Hand-Washing
Hand-washingVideo
Hand-washingtextHand-washingremainsthemostimportantandfundamentalinfectioncontrolmeasure.Handcontactwithpatients,contaminatedclinicalequipmentandwasteisadailyoccurrenceforhealthcareworkers.Thiscananddoesleadtoseriouscross-contaminationandinfectionsinpatientsasyourhandscanpassonthesemicro-organisms.Topreventsuchcrossinfectionshappeninganeffectivehand-washingtechniquemustbeemployed.Hand-washingremainsthemostimportantandfundamentalinfectioncontrolmeasure.Handcontactwithpatients,contaminatedclinicalequipmentandwasteisadailyoccurrenceforhealthcareworkers.Thiscananddoesleadtoseriouscross-contaminationandinfectionsinpatientsasyourhandscanpassonthesemicro-organisms.Topreventsuchcrossinfectionshappeninganeffectivehand-washingtechniquemustbeemployed.Turnonthewaterandadjustthetemperature.Wetallhandsurfaces,includingwrists,underrunningwaterbeforeapplyingthehand-washingagent,thenwashyourhandsinthefollowingorder.RemembertousefrictiononallhandsurfacesRubpalmstogethertocreatealather.Rubrighthandoverbackofleftwithfingersinterlaced,changehandsandcontinue.Rubpalmstogetheragainwithfingersinterlaced.Clasphandsandrubbacksoffingersagainstopposingpalms,changehandsandrepeatRotaterighthandaroundleftthumb,thenrotatelefthandaroundrightthumb.Usefingertipstocleansecentreofpalms.Rotaterighthandaroundleftwrist,changehandsandrepeat.Rinsehandsandturnofftapsusingelbowsorpapertowels.Thenshakeoffexcesswateranddryyourhandthoroughly.Thehand-washingprocessshouldtakeaminimumof10seconds.Tosummarize:RubpalmstogethertocreatealatherRubrighthandoverbackofleftwithfingersinterlaced,changehandsandrepeat.Rubpalmstogetheragainwithfingersinterlaced.Clasphandsandrubbacksoffingersagainstopposingpalms,changehandsandrepeatRotaterighthandaroundleftthumb,thenrotatelefthandaroundrightthumb.Usefingertipstocleansecentreofpalms.Rotatelefthandaroundrightwrist,andfinally,rotaterighthandaroundleftwrist.
Audiointroductiontohand-washing
MoreInformationXMicroorganismsarelivingformsthataretoosmalltobeseenwithouttheaidofamicroscope.Theyareclassifiedintobacteria,fungiandviruses.Somemicroorganismscausediseaseandareassociatedwiththeoutbreaksofinfectioninhospital.Handsshouldbewashed:Beforeandaftercontactwithsusceptiblesites,e.g.wounds.Beforeandaftermanipulationorinsertionofinvasivedevices,e.g.intravenouscannula,urinarycatheters.Beforeandafterpreparingorhandlingfood.Beforeleavingaworkarea.Aftercontactwithcontaminateditems,e.g.linen,equipment.Aftercontactwithbodyfluids.Aftercontactwithapatientbeingisolated.Afterusingthetoilet.
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CONTENTS

GlovingProcedures
GlovingVideo
GlovingtextIfyourinitialriskassessmentfindsthattheprocedureissterilethensterileglovesmustbeworn.Caremustbetakenwhenopeningsterilegloves.Thepackageshouldbeopenedwithoutcontaminatingtheinsideofthepackageorgloves.Theglovesopenupandyouhavealeftandrightglove.Pickupagloveusingtheinsideofthecuffandproceedtoslideyourfreehandinside.Becarefulnottocontaminatetheoutsideoftheglove.Pickupthesecondgloveviathecuffusingyourglovedhandandproceedtoslideyourotherhandinside.Unfoldthecuffsandadjustbothglovestoensureaneatfit.Toremovesterilegloves,youholdthecuffofonegloveandpeelitinsideout.Thisgloveshouldthenbeheldintheotherglovedhand.Thesecondgloveisthenpeeledoffinthesameway.Thisresultsinoneglovebeingwrappedinsidetheotherandmeansthatanycontaminationisheldinsidetheglove.Bothglovescanthenbesafelydisposedofasasingleunitinayellowclinicalwastebag.Theprocedureforputtingonnon-sterileglovesdoespermityoutotouchtheoutsideoftheglove.Alwaysensurethattheglovescoverthewristandfitwell.Whenremovingnon-sterileglovesfollowthesameprocedureasbeforetherebyensuringthattheglovesaredisposedoffasasingleunitintoayellowclinicalwastebag.Thelatexfreeglovesareputoninthesamewayensuringthattheycoverthewristsandfitwell.Againitispermittedtotouchtheoutsideoftheglove.Theseglovesshouldalsoberemovedanddisposedofasasingleunitintoayellowclinicalwastebag.Blueglovesmustbewornwhenworkinginwardandgeneralareas.Yellowglovesarewornifworkinginkitchenordiningareasand,forbathroomandtoiletareas,pinkglovesshouldbeworn.
Audiointroductiontoglovingprocedure
MoreInformationXNonSterileGloves.Theseglovesarenon-sterile,comeinboxesof100andareambidextrous.Thepalmsandfingershaveatextureonthemtogiveyouanextragrip.Theseglovescomeinfoursizes,extrasmall,small,mediumandlarge.Itisimportantthatyouwearthecorrectsizetofityourhand.SterileGloves.Sterilegloveswhicharenitrile(latexfree)areavailableforindividualswitheitheranallergytolatexorworkingwithpatientswithanallergytolatex.NitrileGloves.Theseglovesaresyntheticnitrilepowderfreegloves.Theyhavetexturedfingersandhandsand,althoughtheyarenotassuppleaslatex,theydoprovideprotectionforyourselfandthepatient.Theyshouldbeusedifyouoryourpatienthasalatexallergy.Symptomsofalatexallergycanincludepotentiallylifethreateninganaphylaxis,butalsoreddeningoftheskin,rhinitis,conjunctivitisandasthmasymptoms.
MoreInformation
CONTENTS

AsepticTechnique
AsepticVideo
AseptictextIfyourinitialriskassessmentfindsthattheprocedureissterilethensterileglovesmustbeworn.Caremustbetakenwhenopeningsterilegloves.Thepackageshouldbeopenedwithoutcontaminatingtheinsideofthepackageorgloves.Theglovesopenupandyouhavealeftandrightglove.Pickupagloveusingtheinsideofthecuffandproceedtoslideyourfreehandinside.Becarefulnottocontaminatetheoutsideoftheglove.Pickupthesecondgloveviathecuffusingyourglovedhandandproceedtoslideyourotherhandinside.Unfoldthecuffsandadjustbothglovestoensureaneatfit.Toremovesterilegloves,youholdthecuffofonegloveandpeelitinsideout.Thisgloveshouldthenbeheldintheotherglovedhand.ThesecondgloveisthenpeeledoffinthesamewayThisresultsinoneglovebeingwrappedinsidetheotherandmeansthatanycontaminationisheldinsidetheglove.Bothglovescanthenbesafelydisposedofasasingleunitinayellowclinicalwastebag.Theprocedureforputtingonnon-sterileglovesdoespermityoutotouchtheoutsideoftheglove.Alwaysensurethattheglovescoverthewristandfitwell.Whenremovingnon-sterileglovesfollowthesameprocedureasbeforetherebyensuringthattheglovesaredisposedoffasasingleunitintoayellowclinicalwastebag.Thelatexfreeglovesareputoninthesamewayensuringthattheycoverthewristsandfitwell.Againitispermittedtotouchtheoutsideoftheglove.Theseglovesshouldalsoberemovedanddisposedofasasingleunitintoayellowclinicalwastebag.Blueglovesmustbewornwhenworkinginwardandgeneralareas.Yellowglovesarewornifworkinginkitchenordiningareasand,forbathroomandtoiletareas,pinkglovesshouldbeworn.
CONTENTS

RiskAssessment-Elderly
ElderlyVideo
ElderlytextAriskassessmentwillmostofteninvolveadialoguebetweentheprimarycaregiverandothersinvolvedinthepatientscare.Thepurposeofthisdialogueistocommunicatethepatient'scurrenthealthstatusandtoassesstheirphysicalandpsychologicalneeds.Priortoundertakinganyprocedurethenurseshould:Explaintothepatientwhattheprocedureinvolvesandgaininformedconsent.Ifforexampletheprocedureinvolvesvenepuncture,usethistimetoviewthevenousaccesssoagoodclinicaljudgementcanbemadeastothemostsuitablevein.Beawareoftherisksinvolvedmainlythatthepatientcouldbecomedistressedandtheirbehaviourmaybecomeunpredictable.Theliabilitymarketarisingoutofcareoftheelderlysettingsissteadilyincreasing.Itisthereforeimportanttoappreciatetheneedforafullandaccurateriskassessmentofeachpatientwithintheeldercaresetting.Tosafeguardyourselfandyourpatientitisgoodpracticetoinvolveasecondpersonwiththeprocedure.Thismayalsohelptoreassurethepatientduringtheprocedure.
Audiointroductiontoriskassessment-Elderly
MoreInformationXInformedConsent.Informedconsentistheprocesswherebythepatientisinformedabouttheoptionsforthediagnosisandtreatmentoftheircondition.Inaddition,therisksoftheprocedureaswellasthebenefitsaredescribedtothepatientsothatthepatientcanmakearationaldecisionregardingwhathe/shewantstobedone.
MoreInformation
CONTENTS

RiskAssessment-Physiotherapy
PhysiotherapyVideo
PhysiotherapytextThereareanumberofinfectioncontrolriskfactorsforhealthcareworkersworkingwithinahospitalTrust.Priortoseeingapatientanassessmentofthepatientscurrenthealthstatusshouldbemade.Afullandaccurateassessmentisnecessarypriortotreatinganypatientand,providingitiscarriedoutaccurately,mayhelptoreducetheriskofaccidentsorincidentsforbothpatientandclinician.Treatingpatientswithchestconditionsisamajorpartoftheroleofthephysiotherapist.Withanyroutinechestphysiotherapythereisariskofstaffcontactwithsputum.Thismayoccureitherorallywithanassistedcough,viasuctionwithyankertomouth,orcatheterviaatracheostomy.Otherrisksmayarisewhencheckinganinnertubeofatracheostomy,emptyingsuctioncontainersorchangingsuctiontubing.Measurestoreducerisksinclude:Thephysiotherapistmustwearglovesanda plasticapronforallproceduresthatinvolvecontactwithbodilyfluids;Thesuctionapparatusshouldbecheckedtoseethatitisworkingpriortoengaginginanyprocedure;Duringtheprocedurethephysiotherapistshouldavoidstandingdirectlyoverthepatientwhensuctioning;Thephysiotherapistshouldalsodoubleglovewhensuctioningwithacatheterviaatracheostomy;Usedsuctioncathetersshouldbedisposedofimmediatelyintoayellowclinicalwastebag;Whentheprocedureiscomplete,gloves,apronandotherclinicalwasteshouldalsobedisposedofintotheyellowclinicalwastebag;Thisbagshouldthenbesealedbeforebeingfinallydisposedintoaclinicalwastebin.Handsshouldthenbewashedattheendoftheprocedure.
CONTENTS

RiskAssessment-Paediatrics
PaediatricsVideo
PaediatricstextTomeettheirphysicalandpsychosocialneedsyoungchildren,undergoingcannulationorphlebotomy,requirethoughtfulholisticpreparation.Thiscanbeachallengingandtimeconsumingactivitybutitisanimportantinvestmentintermsofgainingthechild'strustandcompliancewithfutureproceduresandtreatments.Animportantpartofgainingthechild'strustandcomplianceis,whenpossible,tofacilitatethechild'sassistancewiththeprocedure.Theremovalofacannulasecuredwithanadhesivedressinghasthepotentialofallowingthechildtohelppeelbacktheadhesivedressingunderthestrictsupervisionofthenurse.Thereareobviousrisksinvolved,butiftheprocedureisnotcarefullycontrolled,respectingthechild'sneedforinvolvement,theprocedurecanbecomepotentiallyhazardous.Ifthechildbecomesdistressedandfrightenedandthenursetriestoremovethedressingandcannularapidly,withoutthechild'sfullagreementandco-operation,thechild'sactionsmaybecomeunpredictableleadingtoapotentialsharpsinjury.Itispreferablethatthenursewhohasbeenconsistentlyinvolvedwiththechild'streatment,andwhohasagoodrapportwithhim/her,carriesouttheprocedure.Thechild'sco-operationshouldbeagreedandtherequireddressingavailablepriortocommencingtheprocedure.Thenursemustwearprotectiveglovesandapronandshouldmaintainadialoguewiththechildthroughout.Whenthecannulaisremoveditmustbedisposedofsafelyintoasharpscontainer.Awater-proofdressingisthenplacedoverthepuncturesite.
MoreInformationXPhlebotomy.Theprocedureofwithdrawingbloodfromabloodvesselusinganeedle.Cannulation.Theinsertionofaflexibletubecontaininganeedleintoabloodvessel.
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CONTENTS

RiskAssessment-Laboratories
LabsVideo
LaboratoriestextThelaboratorywithinahospitalreceiveshundredsofclinicalspecimenseveryday.Assuchworkerswithinthelabareatriskofexposuretosharpsorsplashinjury.Itistheresponsibilitythereforeofeachmemberofstaffworkingwithinthelaboratorytoensurethathealthandsafetypoliciesareadheredtorigidly.Alaboratorycoat,properlyfasteneduptotheneck,shouldalwaysbewornwhenhandlingspecimens.Glovesmustalsobeworn,particularlywhenhandlinginfectiousmaterialand“leaking”specimens.Furthermoreeyeprotectionshouldalsobewornwhenusingacidsorbases.Intheeventofaspecimenbecomingdamagedduringtransporttothelabthefollowingproceduremustbeadheredto:Anincidentformmustbecompleted.Thedamagedspecimenisthendisposedofintoasharpscontainer.AnybloodspillageisthentreatedwithHypochloritesolution.Thespillshouldthenbecleanedupusingpapertowelsasnecessary.Thepapertowelsmustthenbedisposedofintoayellowclinicalwastebagalongwiththeglovesforincineration.Whenaspecimenisreceivedinthelabitistheresponsibilityoflaboratorystafftocheckthatthedetailsonthespecimenmatchthedetailsontheattachedlaboratoryform.Anydiscrepanciesmustbereportedandanincidentformcompleted.Whenthelaboratorystaffaresatisfiedthatthedetailsarecorrecttherequestedtestisthencarriedoutonthespecimen.Againitisimportantthatthelaboratorypersonnelwearglovesthroughouttheprocedure.Itshouldalsobenotedthateating,drinkingandsmokingarestrictlyprohibitedwithinthelaboratoryarea.Furthermoreout-doorclothingmustbestoredseparatelyfromlaboratoryclothingtherebyreducingtheriskofcontaminatingoutdoorclothingandcarryinginfectionoutsidethelaboratory.
CONTENTS

Sharps-Venepuncture
VenepunctureVideo
VenepuncturetextPriortocommencingtheprocedurethenursemustfirstlycheckthepatientsdetailsontheirhospitalarmbandtoverifycorrectpatient.Thepatientshouldthenbegivenanadequateexplanationoftheproceduretohelpreduceanxietyandensureco-operation.Alwayscheckthatthetamperproofpapersealisintacttoensuresterilitybeforeusinganyneedletosampleblood.Withaclosedvacuumcontainersystem,suchastheVacutainer,thebloodsampleistransferredfromtheveinviaadouble-endedneedledirectlyintothecollectingtubethusminimisingthepotentialforbloodspillages.Theproceduremustbeexplainedtothepatientandthepatient'sarmshouldbefreeofclothingfromtheelbowdown.Asuitableveinshouldthenbeidentifiedandatourniquetappliedabovetheelbow.Theareaisthencleanedusinganalcoholwipe.Glovesmustbeputonpriortoinsertingtheneedleintothevein.Theneedleshouldbeinsertedatanangleofapproximately15degreestoenterthevein.Rememberlatexorvinylglovesmustbewornwhenhandlinganybloodproductsorbodilyfluids.Oncecompletedremovetheneedlefromthepatient'sarmwhilesimultaneouslypressingasterilewoolorgauzeswabontothesitetostemtheflowofblood.Alwaysdisposeofusedsharpsinanapprovedsharpsbin.ThesharpsbinmustnotbefilledbeyondthedesignatedcapacityStaffareresponsiblefordisposingoftheirownvenepunctureequipment.Remembertokeepglovesonwhiledisposingofequipment.Alwayshaveasharpsbintohandbeforeopeningandusingasharp.Neverre-sheatheusedneedlesbutdiscardimmediatelywiththesyringeintothesharpsbin.Ensurethatclinicalwasteisalsodisposedofintotheproperclinicalwastebag.Donotcompleteanyinformationonthebloodcollectiontubesuntilafterthesamplehasbeentakeninordertoavoidconfusionwithbottlesandclients.Itisveryimportanttocheckthatpatient'sdetailsarecorrectbothonthelaboratoryformsandthespecimenbottle.Thespecimenbottlemustbesealedsecurelywithinthelaboratorybag.Itisalsoimportanttocheckthedetailsonthelaboratoryformsagainsttheclient'sdetailsontheirhospitalarmband.Itisthenthenursesresponsibilitytoensurethatthespecimenissenttothelaboratory.Handsshouldthenbewashed.Rememberthatwearingglovesdoesnoteliminatetheneedtowashyourhandsaftercompletingaprocedure.Theyellowbagcontainingtheclinicalwasteshouldbedisposedofintoalargeclinicalwastebin.Theclinicaltrolleymustbecleanedusinganappropriatedisinfectantagent.ItisimportantthatallsurfaceareasarecleanedasperTrustpolicy.Thetrolleyshouldthenbestoredintheclinicalroom.
Audiointroductiontovenepuncture
MoreInformationXVenepunctureThecollectionoffreshwholebloodfromasuperficialveine.g.mediancubitalveinontheanteriorsurfaceoftheelbow.
MoreInformation
CONTENTS

Sharps-Theatres
TheatresVideo
TheatretextItistheresponsibilityofallstaffworkingwithintheTrusttopromotetheuseofgoodpracticewithregardtothesafedisposalofsharps.Allstaffhaveadutytoprotecttheircolleaguesfrompotentialinjuriesfromsharpsthereforetheyshouldnotdoanythingthatwouldputothersatrisk.Theatreisoneareawherestaff,aspartoftheirdailywork,aremorelikelytohandlesharpsandneedles.Sharpsandneedlesposeaseriousthreattostaffand,assuch,shouldbehandledwithrespect.Staffarealsoexposedtobodyfluids,particularlyblood,andparticularcareshouldbetakentoavoidsplashinjuries.ItistheresponsibilityoftheindividualusinganeedleorsharptodisposeofitsafelyasspecifiedintheTrustpolicy:Eachsharpshouldbedisposedofseparately,SharpsmustbedisposedofintoasharpscontainerThereshouldbenoattemptmadetore-sheatheneedlesTheonusisontheindividualtoensurethatallusedsharpshavebeendisposedofsafelytherebyreducingthepossibilityofasharpbeingplaced,byaccident,intoayellowclinicalwastebag.
CONTENTS

WasteDisposal
WasteVideo
WasteDisposaltextYellowclinicalwastebagsfordisposalmustberemovedfromthebinusingthefootpedalprovided.Handsmustnotbeusedtoopenthebinand,undernocircumstances,shouldyouplaceyourhandsinsidethebin.Thefullbagshouldthenbeclosedusingthe“swanneck”techniqueandsealedwithablacksecuritytie.Clinicalwastecanbehazardous.Inordertoprotectyourselfandyourcolleaguesitisimportantthatfullbagsaresealedsafelyandsecurely.Rememberthismustbedonepriortoremovingthebagfromtheroom.Alwaysensurethatyouleaveanewbag,whichmustbeadequatelysecuredwithinthebin.Rememberclinicalwastebagsshouldalwaysheldawayfromthebodywhenbeingtransportedtothewastedisposalarea.Youwillneedyoursecuritycodetoaccessthisarea.Yellowclinicalwastebagsarethendisposedofintolargeyellowcolourcodedbins.Non-clinicalwasteisdisposedofintoblackhouseholdwastebags.Againfullbagsshouldberemovedusingthefootpedalandglovesmustbewornatalltimes.Thefullbagisthenclosedwithadoubleknotpriortoremovaltothewastedisposalarea.Anewblackbagmustthenbefittedintothebin.Onceagainitisimportanttoensurethatduringtransportationthefullbagisalwaysheldawayfromthebody.Householdwasteisheldinlargeblackcolourcodedbins.EachTrusthasadesignatedareaforthefinaldisposalofbothclinicalandhouseholdwaste.Itisimportantthereforethattheregulationspertainingtowastedisposalareadheredtoi.e.clinicalwasteinyellowcolourcodedbinsandhouseholdwasteinblackcolourcodedbins.Thedomesticmanagershouldbeinformedifthereisanybreachinthisregulation.
Audiointroductiontowastedisposal
MoreInformationX
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SharpsInjury
SharpsinjuryVideo
SharpsinjurytextYellowclinicalwastebagsfordisposalmustberemovedfromthebinusingthefootpedalprovided.Handsmustnotbeusedtoopenthebinand,undernocircumstances,shouldyouplaceyourhandsinsidethebin.Thefullbagshouldthenbeclosedusingthe“swanneck”techniqueandsealedwithablacksecuritytie.Clinicalwastecanbehazardous.Inordertoprotectyourselfandyourcolleaguesitisimportantthatfullbagsaresealedsafelyandsecurely.Rememberthismustbedonepriortoremovingthebagfromtheroom.Alwaysensurethatyouleaveanewbag,whichmustbeadequatelysecuredwithinthebin.Rememberclinicalwastebagsshouldalwaysheldawayfromthebodywhenbeingtransportedtothewastedisposalarea.Youwillneedyoursecuritycodetoaccessthisarea.Yellowclinicalwastebagsarethendisposedofintolargeyellowcolourcodedbins.Non-clinicalwasteisdisposedofintoblackhouseholdwastebags.Againfullbagsshouldberemovedusingthefootpedalandglovesmustbewornatalltimes.Thefullbagisthenclosedwithadoubleknotpriortoremovaltothewastedisposalarea.Anewblackbagmustthenbefittedintothebin.Onceagainitisimportanttoensurethatduringtransportationthefullbagisalwaysheldawayfromthebody.Householdwasteisheldinlargeblackcolourcodedbins.EachTrusthasadesignatedareaforthefinaldisposalofbothclinicalandhouseholdwaste.Itisimportantthereforethattheregulationspertainingtowastedisposalareadheredtoi.e.clinicalwasteinyellowcolourcodedbinsandhouseholdwasteinblackcolourcodedbins.Thedomesticmanagershouldbeinformedifthereisanybreachinthisregulation.
Audiointroductiontosharpsinjury
MoreInformationX
MoreInformation
CONTENTS

MRSA/ClostridiumDifficile/SwineFlu
StrphylococcusAureusisagram-positiveorganismcommonlyfoundonhumanskin.Methicillinisusedinlaboratoriesfortestingsensitivityandresistancetoantibiotics.OrganismswhichareresistanttoMethicillinwillnotrespondtoordinaryantibiotics.MethicillinResistantStaphylococcusAureus(MRSA)isamajorprobleminhospitalstoday.ClostridiumDifficileisamajorcauseofseriousbacterialinfectiousdiarrhoeainhospitalsintheUK.Approximately20%ofpeopleover65yrscarrythebacteriumwithoutsymptoms,butexposuretoantibioticsincreasestheriskofinfection.Anaerobic-producesspores-resistanttodrying,chemicaldisinfectants&alcohol.Thereforealcoholgels&spraysarenoteffective.HANDSMUSTBEWASHEDEFFECTIVELYWITHSOAPStandardIsolationPatientisusuallynursedinasideroom.Duringanoutbreakclustersofpatientsmaybegroupedtogether.Mayalsovisitotherdepartmentsifnecessary.UsedforMRSA,Salmonella&ClostridiumDifficile.Gloves,masks&gownswornasappropriate.Visitingallowedbylimitednumberofclosefamily.Patientbecomesinfectedwhentheyswallowthesporesorbacteria.AntibioticusekillsthenormalfloraandthisallowsClostridiumDifficiletothrive.Itcolonisestheintestineandproducestoxinswhichdamagethegutwallcausingseverediarrhoea,pain,nauseaandmalaise.‘Staffwhofailtowashtheirhandsappropriately,properlyoreffectivelyareunsafeandunprofessional.’(Elliott1996)SwinefluisarespiratorydiseasePandemicNewvirussonoonewillhaveimmunity.EveryoneisatriskHowdoesSwineFluspread?Fluvirusesarespreadthroughdropletsfromnoseandmouthwhencoughingorsneezing.Ifyoucoughorsneezeintoyourhand,thosedropletsandgermsareeasilyspreadfromhandtoanysurface.Ifotherstouchthesesurfacesandthentouchtheirfacetheycanbecomeinfected.HowcanIprotectmyselfandothers?Alwayscarrytissues.Usecleantissuestocoveryourmouthandnosewhenyoucoughandsneeze.Bintissuesaftersingleuse.Washyourhandswithsoapandhotwater(orasanitisergeloften)CATCHITBINITKILLIT
CONTENTS

Q8-RiskassessmentistheabilitytoIdentifypotentialhazardsAvoidresponsibilityAttributeblameIdentifypotentialhazards&risks
Q6-ClinicalwasteshouldbedisposedofintoWhitebagsBlackbagsOrangebagsRedbags
Q5-ToreducetheriskofaccidentthepriorityforthenurseshouldbetoSpendtimesettingupfortheprocedureSpendtimegettingtoknowthechild'sparent/guardianSpendtimegettingtoknowtheindividualchildSpendtimereadingthechild'smedical/nursingnotes
Q7-TheresponsibilityforthedisposalofsharpslieswithThenurseworkingintheareaTheindividualusingthesharpPriortodisposingofvenepunctureequipmentThecareassistant
Q4-Hand-washingagentshouldbeappliedNotatallPriortowettinghandsAttheendoftheprocedureAfterwettinghands
Q3-Thecorrectsequenceforhand-washingisApplyhand-washingagent;washhandsrinseanddryApplyhand-washingagent;wethands,washhands,rinseanddryWethands;applyhand-washingagent,washhands,rinseanddryWethands;washhands,applyhand-washingagent,rinseanddry
Q2-FollowingasharporsplashinjurytheO.H.N.willExaminethewoundsiteTakeadetailedhistoryabouttheinjuryApplyadressingDoallofthese
Q1-InordertoputachildateasethenurseshouldMaintainadialoguewiththeparent/guardianduringtheprocedureMaintainadialoguewithacolleagueduringtheprocedureRemainquietduringtheprocedureMaintainadialoguewiththechildduringtheprocedure
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